I’m Disgusted and Disturbed

[angeloublue22, BSN, RN]

I had an event happen last night that completely disturbed me and I haven’t slept because of it. I’m using this forum to unload and possibly help. I work a psych hospital as an admissions coordinator. I obviously can’t give a ton of details. We accepted a pt from an ER that was supposedly medically clear post drug OD.  Pt was calm and cooperative the entire time there. After transport via Sheriff left their facility. Nurse called to warn me that when they tried to get the pt in the car, the pt fell to the ground and started thrashing her body. They called it behavioral and forced her into the vehicle. Sheriff pulled in after an hour drive and told us he can’t get her out because she's “faking sleeping and even snoring” within 2 seconds I recognized it wasn’t snoring, it was stridor breathing and she was is resp distress: sats in the 80’s, pupils pinned and not reactive and unresponsive, lung wheeze inspiratory and expiratory. 

911 was called and I told them this a true emergency. EMTs arrive I tell them my report and they completely ignore me and sternal rub the pt she grunts but becomes unresponsive again. They see her pupils and confirm what I saw. Then they proceed to scream at the pt and drag her/jerk her out of the car telling her to stop faking it while hitting her head repeatedly on the car roof. Once they get her out she falls to her knees and they are yelling for her to get up and stop trying make it hard on them. Then said fine we’ll do it the hard way. I keep trying to tell them this a true emergency but they pretend I’m not even there. They man handed her on the gurney flipping her limbs around like a rag doll, insulting her. I kept trying to stop them. It was the most horrific tx of a pt I had ever seen in my almost 14 years of nursing. We found out that the hospital had to immediately incubate her and now she’s in the ICU. 

I’m actually having trouble going back to work or ever calling 911 again. I keep thinking about it and I’m sick. My co-worker who was also there is having difficulty dealing too (10 yr ER RN). Obviously, our administration is in uproar and contacting CEO and administrators or the transporting hospital and reporting the EMTs. I have seen blatant disregard for the medical safety of mental pts but never this bad. I’ve also had a lot of struggles with bias toward psych nurses too as we are treated like we don’t know what we are doing and frankly I’m tired of it. I’m not angry for myself, I angry for my pts. I know people are burnt out and psych pts do require different strategies to care but they are people and psych nurses are still nurses with a medical education and experience. That is all you can delete if this is too much info but it helped to write it down. 

[hppygr8ful, ASN, RN, EMT-I]

36 minutes ago, angeloublue22 said:

I had an event happen last night that completely disturbed me and I haven’t slept because of it. I’m using this forum to unload and possibly help. I work a psych hospital as an admissions coordinator. I obviously can’t give a ton of details. We accepted a pt from an ER that was supposedly medically clear post drug OD.  Pt was calm and cooperative the entire time there. After transport via Sheriff left their facility. Nurse called to warn me that when they tried to get the pt in the car, the pt fell to the ground and started thrashing her body. They called it behavioral and forced her into the vehicle. Sheriff pulled in after an hour drive and told us the he can’t her out because she “faking sleeping and even snoring” within 2 seconds I recognized it wasn’t snoring, it was stridor breathing and she was is resp distress: sats in the 80’s, pupils pinned and not reactive and unresponsive, lung wheeze inspiratory and expiratory. 
911 was called and I told them this a true emergency. EMTs arrive I tell them my report and they completely ignore me and sternal rub the pt she grunts but becomes unresponsive again. They see her pupils and confirm what I saw. Then they proceed to scream at the pt and drag her/jerk her out of the car telling her to stop faking it while hitting her head repeatedly on the car roof. Once the get her out she falls to her knees and they are yelling for her to get up and stop trying make it hard on them. Then said fine we’ll do it the hard way. I keep trying to tell them this a true emergency but they pretend I’m not even there. They man handed her on the gurney flipping her limbs around like a rag doll, insulting her. I kept trying to stop them. It was the most horrific tx of a pt I had ever seen in my almost 14 years of nursing. We found out that the hospital had to immediately incubate her and now she’s in the ICU. 
I’m actually having trouble going back to work or ever calling 911 again. I keep thinking about it and I’m sick. My co-worker who was also there is having difficulty dealing too(10 yr ER RN). Obviously, our administration is in uproar and contacting CEO and administrators or the transporting hospital and reporting the EMTs. I have seen blatant disregard for the medical safety of mental pts but never this bad. I’ve also had a lot of struggles with bias toward psych nurses too as we are treated like we don’t know what we are doing and frankly I’m tired of it. I’m not angry for myself, I angry for my pts. I know people are burnt out and psych pts do require different strategies to care but they are people and psych nurses are still nurses with a medical education and experience. That is all you can delete if this is too much info but it helped to write it down. 
 

20 year psych nurse here and remember a time when law enforcement brought in a patient who was refusing to walk, They literally dragged him hog-shackled across hot pavement to get him into the building. When he was In the building I started photo-graphing and documenting his injuries. When the officer asked we why I stated "Because I have to show this **** didn't happen here,"

I completely concur with your bolded statement.

Hppy

[PoodleBreath]

This is horrific. Psych patients are so vulnerable, dismissed, discounted, degraded, with no resources to advocate for themselves. I feel so grateful to know that there are nurses like yourself who work so hard to protect their humanity.

Psych doesn't get a lot of focus, and sadly we need it now more than ever. Not just for specific patients, but I think really for the whole human race. Collectively we are not OK.

People don't like to think about the mental health toll of this pandemic.

Those EMTs behaved like sociopaths. Why do they get a pass to brutalize an unconscious person, like it's just another day at the office - just because that person comes labelled with a diagnosis? I'm so glad your facility is pursuing this.

[angeloublue22, BSN, RN]

What’s nice is that the medical field is small. Someone always know someone. One of RNs I work with actually is friends with a person in the county EMTs crew and is going to help me pursue this. 

[LibraSunCNM, BSN, MSN, CNM]

I'm so sorry this happened to you, and obviously the patient.  Be kind to yourself and don't hesitate to seek counseling to process this horrific event. I'm glad the EMTs are being reported, I hope there are actual consequences.  The lack of empathy in some people in this world is truly heartbreaking.

[JKL33]

First: Good job accurately (or should I say "actually") assessing things.

Glad that your admin is pursuing this; I would still file a report via your facility's incident reporting system if you haven't already.

In addition to the (character) faults already mentioned, there is also significant ignorance/poor knowledge base at play here. It isn't difficult to figure out that there is an emergency in the kind of situation you describe. These people are not fit to be anywhere near patients, just based on skill level alone, not to mention attitude. AND they have committed abuse and neglect.

 

50 minutes ago, angeloublue22 said:

What’s nice is that the medical field is small. Someone always know someone. One of RNs I work with actually is friends with a person in the county EMTs crew and is going to help me pursue this. 

Don't go there. The LAST thing this situation needs is you accidentally diverting the focus of criticism by becoming a focus yourself. The better approach is staying in touch with your own upline about this and conveying your expectation that it be pursued by your facility's administration to the extent that those individuals are removed from patient care roles.

Also, I am not advising you of anything with this part but: In my state I could make a very good case for filing a report with APS and some may say I would be required to as I am a mandated reporter. I just re-reviewed my state's laws and didn't see anything that would disqualify this event from being reported. Something to think about, FYI.

[amoLucia]

29 minutes ago, angeloublue22 said:

What’s nice is that the medical field is small. Someone always know someone. One of RNs I work with actually is friends with a person in the county EMTs crew and is going to help me pursue this. 

Personally, I don't know how DEEPLY I would get involved on an individual level. You are going to make a heap big pile of trouble when the poop hits the fan.

Let the hospital & ambulance co/EMTs settle it out. I could see making a formal confidential complaint to the DOH/Ombudsmans (?) offices. That's their job to investigate and mete out any significant corrective/punitive follow-up. They have much more power than you & RN friend.

TBH, first thing that was coming to my mind was poss retaliatory action against you. Sadly, I'm being FOR REAL.

I totally agree with PP JKL33 for 100% - she just responded faster than me. :)

And thank you for speaking up for the abused pt.

[JBMmom, MSN, NP]

So sorry to read that this happened to your patient, and to you. No one in a medical emergency should be dismissed but sadly this is something that occurs everywhere in society and in healthcare. Even in my own facility I've heard coworkers complaining they've got "just another drunk" on their assignment for the night. We've all had bad experiences with patients detoxing from alcohol or drugs, and I admit that sometimes my own patience can wear thin when I'm trying to dodge a foot coming at my head or pull a patient's nails out of my arm (that happened yesterday). But I try to always remember that person is dealing with an addiction and not making rational decisions about their actions. And the bottom line is no matter what brings a person into my unit, I'm obligated to treat them, and I try to treat them with all the humanity and dignity I would want for my own family member. 

I can't see how a bad day or a bad experience could explain away the treatment that patient received. I hope that they receive the care they need in the ICU, and maybe get the detox help they truly need. 

[EDNURSE20, BSN]

The health care system is a joke. Unfortunately pt receive poor care frequently and things are missed or dismissed by health care workers all the time, for a number of reasons. there’s only so much you can do.

But I give my pt the best care I can, advocate for them and I’m not afraid to go above my manager or doctors if I’m not happy with there response. and that gives me peace, at least I’ve helped one person. I can’t change a whole health care system and I don’t beat myself up about it. 

It’s good your talking about this, and filing that compliant. Just don’t let this issue consume you. 

[Emergent, RN]

Sounds like the hospital DCd from the ER too soon and narcan wore off. The medics are incompetent and abusive, and need to be investigated.

It is bad practice when people don't rule out medical problems in psych patients, before considering that they might be having a behavioral episode. Then to react like it's a personal insult and get angry at the patient, and mistreat the patient, is ridiculous.

I will never forget that we had a patient who was not behaving the way the ER doctor liked. He didn't want to treat this patient because he didn't like people with psychological problems. The nurse was a real mean person,  and she also joined in happily with the doctor in berating this patient. They thought he was just being uncooperative because he wanted a warm place to be.

Then another nurse researched in the computer and said, 'oh this guy is a diabetic, let's check his blood sugar'. The doctor just wanted to kick him out the door without even evaluating anything. It turns out his blood sugar with like 20 or something. An IV and some D50 did the trick. But the whole thing was an example of people getting mad at patients who have mental issues or the homeless. It can lead to disasterous consequences. If you are that burnt out you need to get out of the business.

[macawake, MSN]

On 11/21/2021 at 8:49 AM, Emergent said:

The medics are incompetent and abusive, and need to be investigated.

On 11/21/2021 at 8:49 AM, Emergent said:

It is bad practice when people don't rule out medical problems in psych patients, before considering that they might be having a behavioral episode.

On 11/21/2021 at 8:49 AM, Emergent said:

It turns out his blood sugar with like 20 or something. An IV and some D50 did the trick. But the whole thing was an example of people getting mad at patients who have mental issues or the homeless. It can lead to disasterous consequences. If you are that burnt out you need to get out of the business.

I agree 100% ??

Some patient populations can be quite challenging to deal with but that’s not a valid reason to practice poor nursing/medicine or for dehumanizing a person. 

[macawake, MSN]

OP, I’m very sorry that you had to experience this. After eating your post I’m angered and saddened by the fact that a person was treated this way by healthcare ”professionals”.

I agree with LibraSun that you and your coworker who also witnessed this ought to be offered debriefing/counseling. I hope that you’ve received help to process your thoughts and emotions.

On 11/18/2021 at 7:19 PM, angeloublue22 said:

Then they proceed to scream at the pt and drag her/jerk her out of the car telling her to stop faking it while hitting her head repeatedly on the car roof.
 

Once the get her out she falls to her knees and they are yelling for her to get up and stop trying make it hard on them. Then said fine we’ll do it the hard way. I keep trying to tell them this a true emergency but they pretend I’m not even there. They man handed her on the gurney flipping her limbs around like a rag doll, insulting her. I kept trying to stop them.

Wait a second..  The EMTs screamed at the patient and dragged and jerked her out of the car, but did they also hit her head repeatedly on the car roof? It isn’t clear from your sentence if that last part was them or her. It’s horrible treatment of a patient no matter which of the two scenarios applies, but at least in my country (not the U.S.), actively hitting a person’s head against the roof of the car would make it a suspected assault. In my neck of the woods, that would be something that should be reported to the police for them to investigate. A patient ended up intubated in the ICU after a medical transport. This situation is all kinds of no good. I obviously can’t offer any legal advice, but can only repeat once again. I’m so sorry this happened to you and of course to the patient.

Take care!